Abnormalities of Teeth Flashcards
1
Q
3 causes of focal enamel hypoplasia
A
Idiopathic
Caries
Trauma
2
Q
Describe Turner’s tooth
A
When caries or trauma in a deciduous tooth results in an infection of the developing tooth bud, causing enamel hypoplasia (Turner’s hypoplasia; usually affecting the permanent bicuspids)
3
Q
Which teeth would be affected by generalized enamel hypoplasia manifesting in the 1st year?
A
Incisors
Cuspids
First molars
4
Q
Which teeth would be affected by generalized enamel hypoplasia manifesting at age three?
A
Premolars
Second and third molars
5
Q
Most common disturbance in enamel
A
Fluorosis
6
Q
2 enamel disturbances due to Syphilis
A
Hutchinson’s incisors
Mulberry Molars
7
Q
Period of development for the crowns of deciduous teeth
A
Week 14 in utero to 12 months old
8
Q
Period of development of the crowns of permanent teeth
A
6 months to 15 years old
9
Q
Define fluorosis
A
Excessive fluoride during tooth development
10
Q
Period of development during which fluorosis may occur in order to affect the enamel of permanent teeth
A
After birth and before 6 years
11
Q
Effect of fluorosis
A
Enamel hypoplasia and hypocalcification
12
Q
3 physical appearances of fluorosis
A
- White enamel spots
- Mottle brown areas and white spots
- Pitted irregular discolored enamel
13
Q
Define molar-incisor-hypomineralization
A
Hypomineralization of one to four permanent first molars, incisors are affected frequently. May fracture or become carious
14
Q
Describe the appearance of molar-incisor hypomineralization
A
White/yellow or brown enamel
15
Q
Bacteria causing syphilis
A
Treponema pallidum (a spirochete)
16
Q
3 types of post-developmental loss of tooth structure
A
- Attrition
- Erosion
- Abfraction
17
Q
Define attrition
A
Loss of tooth structure due to the mechanical action of mastication
18
Q
2 pathologic causes of attrition
A
Bruxism
More abrasive diets
19
Q
Effect of attrition on dentin
A
Formation of tertiary or reparative dentin
20
Q
Define abrasion
A
Abnormal loss of tooth structure due to friction
21
Q
5 potential causes of abrasion
A
- Toothbrushes
- Toothpastes
- Toothpicks
- Dental floss
- Pipe smokrs who chew on stem of pipe
22
Q
Define erosion
A
Loss of tooth structure due to non-bacterial chemical causes
23
Q
2 causes of erosion on labial surfaces of teeth
A
Citrus fruits
Carbonated beverages
24
Q
3 causes of erosion on lingual surfaces of teeth
A
Bulimia
Chronic vomiting
Pregnancy (morning sickness)
25
Occupational cause of erosion
Welders (acidic gases inhaled through the mouth)
26
Define abfraction
Loss of tooth structure from occlusal stresses (cracked enamel is then lost through erosion or abrasion)
27
Define internal resorption as a form of tooth loss
Form of tooth loss that begins in the pulp (idiopathic)
28
Describe the appearance of a tooth having undergone internal resorption
Tooth may start to develop a pink color
29
Treatment of tooth affected by internal resorption
Obtain radiograph --\> root canal in time may prevent tooth from being lost
30
Define external resorption as a form of tooth loss
Loss of tooth structure that begins on the surface
31
6 potential causes of external resorption
* Idiopathic if cervical
* Mid-root = trauma
* Apex = inflammatory
* Impacted teeth may undergo resorption
* Orthodontic movements
* Transplanted or re-implanted teeth
32
Define ankylosis
Fusion of cementum or dentin to bone after loss of periodontal membrane
33
Tooth most commonly affected by ankylosis
Primary second molar (may lead to submerged deciduous molar)
34
Potential effect of tetracylcine on teeth
Yellowish-brown intrinsic discoloration of teeth (incorporated into bone and enamel); fluorescent under U-V light
35
When should tetracylcine not be used in order to avoid tooth discoloration
Do not use in pregnant women in second and third trimester and until age seven
36
Define congenital porphyria
Excessive porphyrins in blood
37
2 effects of congenital porphyria
Pinkish brown teeth that fluoresce bright scarlet with U-V light
Skin = photosensitivity
38
2 effects of biliary atresia
Elevated bilirubin
Dark green teeth
39
Define erythroblastosis fetalis
Hemolytic anemia due to Rh-negative mother carrying an Rh-positive fetus causing maternal antibodies to form
40
Effects of erythroblastosis fetalis on teeth
Bluish-green to yellowish grey teeth (deciduous only)
41
2 types of disturbances of tooth size
Microdontia (true/relative)
Macrodontia (true/relative)
42
Cause of true generalized microdontia
Pituitary dwarfism
43
Cause of relative generalized microdontia
Big jaws
44
First and seconf most common examples of localized microdontia
Peg lateral
Maxillary third molar
45
Example of a supernumary microdont
4th molar
46
Cause of true generalized macrodontia
Pituitary gigantism
47
Tooth most commonly affected by localized macrodontia
Mandibular 3rd molars
48
2 conditions that may result in macrodontia
Hemifacial hypertrophy
Oculo-facial-cardio-dental syndrome
49
2 disturbances of tooth number
Total or partial anodontia
Supernumary teeth
50
Define total anodontia
No deciduous NOR permanent teeth
51
3 most commonly congenitally missing permanent teeth
Third molars
Maxillary lateral incisors
Second premolars
52
Most commonly congenitally missing deciduous tooth
Maxillary lateral (although uncommon)
53
Potential cause of pseudoanodontia
Gingival hyperplasia (fibromatosis) causing the gums to completely cover the teeth
54
When does ankylosis usually occur
In deciduous teeth if permanent tooth is missing
55
Define ectodermal dysplasia
Inherited syndrome where two or more ectodermally derived anatomic structures are missing
56
3 potential manifestations of ectodermal dysplasia
* Hypoplasia or aplasia of tissues such as skin, hair, nails, teeth, salivary or sweat glands
* Missing teeth
* Abnormal shape of teeth
57
Inheritance of hypohidrotic ectodermal dysplasia
X-linked
58
6 manifestations of hypohidrotic ectodermal dysplasia
* Partial anodontia
* Conical teeth
* Fine sparse hair
* Lack of sweat glands
* Nails - dystrophic brittle
* Dry mouth (lack of salivary glands)
59
In which are are supernumary teeth more often found?
90% in maxilla (10% in mandible)
60
Most common supernumary teeth
Mesiodens (supernumary upper anterior tooth)
61
3 supernumary teeth found in the mandible
Premolars
4th molars
Incisors
62
2 examples of syndromes to rule out if multiple supernumary teeth are present
* Cleidocranial dysplasia
* Gardner's Syndrome
63
5 characteristics of cleidocranial dysplasia
* Lack of clavicles (long neck appearance)
* Frontal, parietal, and occipital bossing
* Hypertelorism (widely spaced eyes)
* Unerupted supernumary teeth
* Failure of eruption of permanent teeth
64
Inheritance pattern of Gardner's Syndrome
Autosomal dominant
65
4 characteristics of Gardner's Syndrome
* Multiple osteomas
* Colonic polyps (premalignant adenomas) since associated with FAP
* Impacted permanent and supernumary teeth
* Epidermal and pilar cysts and skin fibromas
66
4 disturbances in eruption
* Premature eruption
* Delayed eruption
* Impacted teeth
* Eruption sequestrum
67
Define natal teeth
Premature eruption; deciduous teeth present at birth. Avoid extraction
68
Usual natal teeth
Mandibular central incisors
69
Define neonatal teeth
Premature eruption; deciduous teeth which erupt within first 30 days
70
Condition to rule out if entire premature eruption occurs
Hyperthyroidism
71
3 conditions that may cause delayed eruption
* Rickets
* Cleidocranial dysplasia
* Cretinism (stunted physical and mental growth due to congenital hypothyroidism)
72
Local factor that may cause delayed eruption
Gingival fibromatosis (physically blocks tooth eruption)
73
Define impaction
Obstruction preventing normal eruption
74
List the teeth most frequently impacted in order of frequency (most to least)
1. Mandibular/maxillary third molars
2. Maxillary cuspids
3. Mandibular second premolars
4. Supernumary teeth
75
Usual causes of impaction
Crowding/ other teeth, but may be due to cysts or tumors
76
4 classifications of 3rd molar impaction
* Mesioangular
* Distoangular
* Horizontal
* Vertical
(Can help determine whether you should extract yourself or refer to surgeon)
77
5 indications for 3rd molar extraction when impacted
* Root resorption
* Infection
* Pain
* Cyst
* External resorption
78
Define eruption sequestrum
Small fragment of bone in soft tissues over an erupting mandibular molar tooth
79
Define dilaceration
Extraordinary curving of roots resulting in difficult extractions and endodontics
80
Define taurodontism
Bull teeth; elongated crowns and apically displaced furcations
81
4 syndromes/conditions associated with taurodontism
* Amelogenesis imperfecto
* Down syndrome
* Klinefelter's syndrome
* Tricho-dento-osseous syndrome (Kinky hair)
82
Race most affected by taurodontism
Inuit
83
Define dens invaginatus
Tooth within a tooth (dens in dente); exaggeration of the lingual pit that may be superficial or deep. Usually bilateral
84
Most commonly affected tooth by dens invaginatus
Maxillary lateral incisor
85
Usual management of dens invaginatus
Placement of a prophylactic composite filling
86
Define dens evaginatus
Supernumary cusp, often bilateral; anomalous cusp/tubercle on occlusal surface
87
Usual teeth affected by dens evaginatus
Premolars
88
Races most often affected by dens evaginatus
Asians
Inuit
Native Americans
89
Potential consequence of abrasion on dens evaginatus and how to deal with it
Abrasion may lead to pulp exposure --\> identify problem early and correct with occlusal adjustment of opposing tooth
90
Define talon cusp
Supernumary cusps; abnormal lingual cusps
91
Syndrome in which talon cusps are a feature
Rubenstein-Tabes syndrome (unlike dens evaginatus, which is not a feature)
92
3 teeth most frequently affected by supernumary roots
Mandibular canines
Premolars
Third molars
93
Define gemination
Attempt to form two teeth from one enamel organ; partial division of a single tooth germ/ two crowns that share one root canal
Usually anteriors
94
Define fusion
Extra wide crown; joining of two developing tooth bods involving either entire tooth or only roots. Root canals separate or shared
95
Difference in tooth number between fusion and gemination
Gemination = normal number of teeth
Fusion = missing one tooth
96
Define concrescence
Two completely formed teeth are joined by cementum
97
Teeth usually affected by concrescence
Maxillary 2nd and 3rd molars
98
Define hypercementosis
Roung bulbous roots due to excess production of cementum. May be acquired (related to inflammation), idiopathic or associated with other diseases
99
2 diseases associated with hypercementosis
Paget's disease of bone
Hyperpituitarism
100
Define enamel pearls
Cervical enamel projection; droplets of ectopic enamel found on roots of teeth
101
Teeth most commonly affected by enamel pearls
Maxillary molars
102
Why must one be cautious when removing enamel pearls?
May have a pulp horn
103
Define amelogenesis imperfecta
Inherited defect in enamel in absence of a systemic disorder or syndrome. Various patterns of inheritance
NOTE: At least 14 subtypes phenotypic classification Witkop. Better classificaiton would be molecular based - related gene defects
104
3 stages of enamel formation
1. Elaboration of organic matrix
2. Mineralization of matrix
3. Maturation of enamel
105
Define hypoplastic amelogenesis imperfecta
Inadequate deposition of enamel matrix. Generalized (localized) small pits and smooth patterns
106
Define hypocalcified amelogenesis imperfecta
Normal enamel thickness but soft and friable. Yellow-brown on eruption
107
Define hypomaturation amelogenesis imperfecta
Normal hardness of enamel but chips away easily. Pigmented pattern, X-linked and snow capped
108
What form of amelogenesis imperfect has taurodontism
Hypomaturation/hypoplastic form
109
Inheritance pattern of dentinogenesis imperfecta
Autosomal dominant
110
Describe dentinogenesis imperfecta (5 points)
* Translucent teeth
* Enamel fractures easily
* Constriction at CEJ (bell-shaped crown)
* Short blunt roots
* Opacification of pulps or may have enlarged pulp chambers
111
Inheritance pattern of osteogenesis imperfecta with opalescent teeth
Autosomal dominant or recessive
112
2 other characteristics of osteogenesis imperfecta with opalescent teeth
Blue sclera
Multiple bone fractures with normal activities
113
Inheritance pattern of dentin dysplasia
Autosomal dominant
114
2 types of dentin dysplasia
Type I radicular
Type II coronal
115
DIfference between type I and type II dentin dysplasia
Type I = color of both dentitions normal
Type II = color of primary teeth opalescent
116
3 characteristics of type I dentin dysplasia
Also known as Rootless Teeth:
* Periapical lesions common
* Roots very short
* Pulps obliterated
117
Describe the pulp in Type II dentin dysplasia
Thistle tube pulps
118
Define regional odontodysplasia
Teeth in a region have thin enamel and enlarged pulp chambers. Known as "Ghost Teeth".
119
2 possible causes of regional odontodysplasia
Mostly idiopathic but may be associated with a hemangioma or vascular malformation
120
Usual consequene of regional odontodysplasia
Extractino of teeth usually necessary
